Psychotherapy Articles

When I was struggling with my eating disorder, I’d have particularly awful days. Often, it involved me crying into my carpet and wishing I didn’t exist. In those moments, when life was heavy and pressing, I was willing to reach out for help, but I didn’t know where to begin.

My eating disorder was a shameful secret, so naturally I didn’t want to elaborate to the random secretary who answered the phone. I did leave an awkward message or two on a voicemail.

Last month, in this piece, psychologist Ryan Howes, Ph.D, shared three top obstacles in therapy: feeling shame for having problems and needing to go to therapy in the first place; not knowing how therapy works; and having to trust a total stranger with our innermost thoughts and feelings.

This month we asked Joyce Marter, LCPC, a psychotherapist who pens the Psych Central blog “Psychology of Success,” to share three additional obstacles in therapy and how to overcome them.

Things have changed a lot in the past 30 years when it comes to our ideas about depression. In the 1980s and even the 1990s, people often still saw it as a moral weakness, a sign of being “crazy,” or as something to be dismissed completely.

Today most people not only know someone who has struggled openly with depression, but they can probably also rattle off a handful of symptoms just from watching the many depression medication television commercials that dominate the airwaves. The voiceover asks “Are you always sad and tearful? Have you lost interest in things you used to enjoy? If so, ask your doctor about this medication.”

If you’re new to therapy, you may not know what to expect. To help you make the most of the process, we asked seasoned clinical psychologist Ryan Howes, Ph.D, to share the three biggest obstacles in therapy along with how to overcome each one.

School-aged children (6 to 11 years) often wonder why they are sitting in your office for therapy. Many thoughts and emotions are associated with coming to a mental health provider’s office, including curiosity, anxiety and even fear. In order to help kids deal with whatever may be bringing them to therapy, it’s important that they understand why they may need such a service.

Kids are most receptive to messages that are age-appropriate and stated in ways that they can make sense of and understand. For elementary school-aged children, a mindful analogy is often an excellent tool to employ. Analogies help children make sense of concepts that often aren’t easily explained.

Therapy is about the fine art of asking directive questions. So what should you expect from your first appointment with a counselor, social worker or psychologist?

The answer is simple: You should expect easy, brain-expanding questions, questions and more questions. A “change map” (often called “treatment goals”) is then created to guide you in solving the problems that are currently plaguing you.

Here are 10 of the more typical questions a psychotherapist will ask to prime your mental pump for positive change during the counseling process. Following the question is an example of what it might sound like.

October 10 is World Mental Health Day and the World Health Organization (WHO) has declared the 2014 focus to be schizophrenia. The people at the William Glasser Institute – US (WGI-US) took to heart Dr. Glasser’s mandate that society treat mental health as a public health issue. When we do that, the focus is on prevention and mental health rather than treatment, psychopharmacology and mental illness.

Most people understand the steps they can implement to improve their physical health. WGI-US is geared toward helping people understand the habits they can develop that will improve their mental health. So on October 10, while other organizations are focusing their efforts on raising awareness for mental illness, WGI-US will be providing 24-hour programming on prevention, mental health, resilience and happiness.

“We were texting back and forth about a project we were working on together. Gradually, the texts became a little more familiar. Over time we started sharing more, and … I guess you could say I’m involved in an emotional affair. I want to stay married, but I feel like I love this other person.”

I have heard some version of this explanation several times over the last year alone. In just the last few months, 80 percent of my new couples cases in therapy have centered on emotional affairs perpetuated through electronic communications. In every instance, a smartphone facilitated more frequent and ongoing connection than a traditional computer or laptop.

Going to therapy is hard enough for adults. Stigma stops many of us from picking up the phone and making an appointment. Plus, therapy is hard work. It often requires revealing our vulnerabilities, delving into difficult challenges, changing unhealthy patterns of behavior and learning new skills.

So it’s not surprising that kids might not want to go either. This resistance only escalates when they misunderstand how therapy works. “Many children are afraid or nervous to go to therapy, especially if they have the belief that they are in trouble or because they are ‘bad,’” said Clair Mellenthin, LCSW, a child and family therapist.

In October 2009, I wrote my first piece in a series for Psych Central on the changing landscape of therapists online. Psychotherapists Unmasked on the Internet reflected upon a conversation I’d had with my psychiatrist father five years prior, who gave me an earful around the ethics of having my picture up on my website.

What he didn’t realize at that time was that websites were becoming an important marketing tool in our profession and that a move toward therapist demystification was occurring. A hearty discussion among many in our field around how to navigate it all was under way.